European Heart Journal Advance Access originally published online on September 23, 2005
European Heart Journal 2005 26(24):2637-2643; doi:10.1093/eurheartj/ehi496
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Correspondence between left ventricular 17 myocardial segments and coronary arteries
1Departament de Física de la Universitat Autònoma, Barcelona, Spain
2Servei de Cardiologia, Hospital Universitari Vall d'Hebron, P. del Vall d'Hebron 119-129, 08035 Barcelona, Spain
3Department of Radiology, Emory University, Atlanta, Georgia
4Servei de Medicina Nuclear, Hospital Universitari Vall d'Hebron, Barcelona, Spain
Received 3 May 2005; revised 22 August 2005; accepted 25 August 2005; online publish-ahead-of-print 23 September 2005.
* Corresponding author. Tel: +34 93 2746100 ext. 6681; fax: +34 93 2746063. E-mail address: jcandell{at}vhebron.net
Aims The last guidelines recommend a standardized 17-segment model for tomographic imaging of the left ventricle. The aim of this study is to analyse the correspondence of the 17 left ventricular segments with each coronary artery by myocardial perfusion SPECT studies.
Methods and results Fifty patients selected for percutaneous revascularization of one coronary artery [24 left anterior descending (LAD), 15 right coronary artery (RCA), and 11 left circumflex (LCX)] were included. The 99mTc-labelled compound was injected immediately after the inflation of the balloon during percutaneous coronary angioplasty. At least 90 s of complete occlusion time was required. Maximal contour of regions of hypoperfusion corresponding to each coronary artery occlusion were delineated over the polar map of 17 segments. Nine segments corresponded to only one coronary artery: eight to LAD (basal anterior, basal anteroseptal, mid-anterior, mid-anteroseptal, apical anterior, apical septal, apical lateral, and apex) and one to LCX (basal anterolateral). Basal inferoseptal, mid-inferoseptal, and apical inferior segments could correspond to LAD or RCA. Basal inferior, basal inferolateral, mid-inferior, and mid-inferolateral segments could correspond to RCA or LCX, whereas the mid-anterolateral segment could correspond to LAD or LCX.
Conclusion The most specific segments (anterior, anteroseptal, and all apical segments except the infero-apical) correspond to LAD but no segment can be exclusively attributed to the RCA. Inferoseptal segments can be attributed to LAD or RCA, inferior and inferolateral segments to RCA or LCX, and mid-anterolateral segment to LAD or LCX.
Key Words: Coronary disease • Scintigraphy • Angiography • Angioplasty
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